892 resultados para SUCCESSIONAL STAGE


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PURPOSE: Primary bone lymphoma (PBL) represents less than 1% of all malignant lymphomas. In this study, we assessed the disease profile, outcome, and prognostic factors in patients with Stages I and II PBL.¦PATIENTS AND METHODS: Thirteen Rare Cancer Network (RCN) institutions enrolled 116 consecutive patients with PBL treated between 1987 and 2008 in this study. Eighty-seven patients underwent chemoradiotherapy (CXRT) without (78) or with (9) surgery, 15 radiotherapy (RT) without (13) or with (2) surgery, and 14 chemotherapy (CXT) without (9) or with (5) surgery. Median RT dose was 40 Gy (range, 4-60). The median number of CXT cycles was six (range, 2-8). Median follow-up was 41 months (range, 6-242).¦RESULTS: The overall response rate at the end of treatment was 91% (complete response [CR] 74%, partial response [PR] 17%). Local recurrence or progression was observed in 12 (10%) patients and systemic recurrence in 17 (15%). The 5-year overall survival (OS), lymphoma-specific survival (LSS), and local control (LC) were 76%, 78%, and 92%, respectively. In univariate analyses (log-rank test), favorable prognostic factors for OS and LSS were International Prognostic Index (IPI) score ≤1 (p = 0.009), high-grade histology (p = 0.04), CXRT (p = 0.05), CXT (p = 0.0004), CR (p < 0.0001), and RT dose >40 Gy (p = 0.005). For LC, only CR and Stage I were favorable factors. In multivariate analysis, IPI score, RT dose, CR, and CXT were independently influencing the outcome (OS and LSS). CR was the only predicting factor for LC.¦CONCLUSION: This large multicenter retrospective study confirms the good prognosis of early-stage PBL treated with combined CXRT. An adequate dose of RT and complete CXT regime were associated with better outcome.

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IntroductionLe lymphome primaire de l'os (LPO) représente moins de 1% de tous les lymphomes malins. Dans cette étude, nous avons évalué le profil de la maladie, les résultats thérapeutiques, et les facteurs pronostiques d'une série consécutive de patients atteints de LPO de stade I et II. Matériel et méthodeDans treize institutions du Réseau des Cancers Rares (Rare Cancer Network), 116 patients ont été traités pour un LPO entre 1987 et 2008, et sont l'objet de cette étude rétrospective. Quatre-vingt-sept patients ont subi une chimioradiothérapie (CXRT) sans (78), ou avec (9) une chirurgie, 15 ont bénéficié de radiothérapie (RT) sans (13), ou avec (2) chirurgie, 14 d'une chimiothérapie (CXT) sans (9), ou avec (5) chirurgie. La dose médiane de RT était de 40 Gy (4-60). Le nombre médian de cycles de CXT était de 6 (2-8). Le suivi médian était de 41 mois (6-242). RésultatsLe taux de réponse global à la fin du traitement était de 91% (74% de réponses complètes et 17% de réponses partielles). Une récidive locale ou une progression ont été observées chez 12 (10%) patients et une récidive systémique chez 17 (15%) patients. La survie globale, la survie spécifique, et le contrôle local à 5 ans ont été de 76%, 78% et 92%, respectivement. En analyse univariée (log-rank test), les facteurs pronostiques favorables pour la survie globale et la survie spécifique étaient: un indice pronostique international (IPI) inférieur ou égale à 1 (P = 0.009), un grade histologique élevé (P = 0.04), une CXRT (P = 0.05), une CXT (P = 0.0004), une réponse complète (P <0.0001), et une dose de supérieure à 40 Gy (p = 0.005). Concernant le contrôle local, seules la rémission complète et stade I ont été des facteurs favorables. En analyse multivariée, le score IPI, la dose de RT, la rémission complète, et la CXT ont influencé le résultat de façon indépendante en ce qui concerne la survie globale et la survie spécifique. La rémission complète a été le seul facteur prédictif pour le contrôle local. ConclusionCette étude multicentrique rétrospective confirme le bon pronostic du LPO de stade précoce traité par une combinaison de chimio-radiothérapie. Une dose de suffisant de radiothérapie et un nombre adéquat de cycles de chimiothérapie ont été suivis des résultats les plus favorables.

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RAPPORT DE SYNTHÈSE : Les profils des granules cytotoxiques des cellules T CD8 mémoires sont corrélés à la fonction, à leur état de différentiation et à l'exposition à l'antigène. Les lymphocytes T-CD8 cytotoxiques exercent leur fonction antivirale et antitumorale surtout par la sécrétion des granules cytotoxiques. En général, ce sont l'activité de dégranulation et les granules cytotoxiques (contenant perforine et différentes granzymes) qui définissent les lymphocytes T-CD8 cytotoxiques. Dans cette étude, nous avons investigué l'expression de granzyme K par cytométrie en flux, en comparaison avec l'expression de granzyme A, granzyme B et de perforine. L'expression des granules cytotoxiques a été déterminée dans lymphocytes T-CD8 qui étaient spécifiques pour des différents virus, en particulier spécifique pour le virus d'influenza (flu), le virus Ebstein Barr (EBV), le virus de cytomégalie (CMV) et le virus de l'immunodéficience humaine (HIV). Nous avons observé une dichotomie entre l'expression du granzyme K et de la perforine dans les lymphocytes T-CD8 qui étaient spécifiques aux virus mentionnés. Les profils des lymphocytes T-CD8 spécifiques à flu étaient positifs soit pour granzyme A et granzyme K soit pour le granzyme K seul, mais dans l'ensemble négatifs pour perforine et granzyme B. Les cellules spécifiques à CMV étaient dans la plupart positives pour perforine, granzyme B et A, mais négatives pour le granzyme K. Les cellules spécifiques à EBV et HIV étaient dans la majorité positives pour granzyme A, B et K, et dans la moitié des cas négatives pour la perforine. Nous avons également analysé, selon les marqueurs de mémoire de CD45 et CD127, les profils de différentiation cellulaire: Les cellules avec les granules cytotoxiques contenant exclusivement le granzyme K, étaient associées à un état de différentiation précoce. Au contraire, les protéines cytolytiques perforine, granzyme A et B, correspondent à une différentiation avancée. En outre, les protéines perforine et granzyme B, mais pas les granzymes A et K, sont corrélées à une activité cytotoxique. Finalement, des changements dans l'exposition d'antigène in vitro et in vivo suivant une infection primaire d' HIV ou une vaccination modulent le profil de granules cytotoxiques. Ces résultats nous permettent d'étendre la compréhension de la relation entre les différents profils de granules cytotoxiques des lymphocytes T-CD8 et leur fonction, leur état de différentiation et l'exposition à l'antigène.

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The objective of this work was to compare the relative efficiency of initial selection and genetic parameter estimation, using augmented blocks design (ABD), augmented blocks twice replicated design (DABD) and group of randomised block design experiments with common treatments (ERBCT), by simulations, considering fixed effect model and mixed model with regular treatment effects as random. For the simulations, eight different conditions (scenarios) were considered. From the 600 simulations in each scenario, the mean percentage selection coincidence, the Pearsons´s correlation estimates between adjusted means for the fixed effects model, and the heritability estimates for the mixed model were evaluated. DABD and ERBCT were very similar in their comparisons and slightly superior to ABD. Considering the initial stages of selection in a plant breeding program, ABD is a good alternative for selecting superior genotypes, although none of the designs had been effective to estimate heritability in all the different scenarios evaluated.

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The V-ATPase V(0) sector associates with the peripheral V(1) sector to form a proton pump. V(0) alone has an additional function, facilitating membrane fusion in the endocytic and late exocytic pathways. V(0) contains a hexameric proteolipid cylinder, which might support fusion as proposed in proteinaceous pore models. To test this, we randomly mutagenized proteolipids. We recovered alleles that preserve proton translocation, normal SNARE activation and trans-SNARE pairing but that impair lipid and content mixing. Critical residues were found in all subunits of the proteolipid ring. They concentrate within the bilayer, close to the ring subunit interfaces. The fusion-impairing proteolipid substitutions stabilize the interaction of V(0) with V(1). Deletion of the vacuolar v-SNARE Nyv1 has the same effect, suggesting that both types of mutations similarly alter the conformation of V(0). Also covalent linkage of subunits in the proteolipid cylinder blocks vacuole fusion. We propose that a SNARE-dependent conformational change in V(0) proteolipids might stimulate fusion by creating a hydrophobic crevice that promotes lipid reorientation and formation of a lipidic fusion pore.

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A two-stage mixing process for concrete involves mixing a slurry of cementitious materials and water, then adding the slurry to coarse and fine aggregate to form concrete. Some research has indicated that this process might facilitate dispersion of cementitious materials and improve cement hydration, the characteristics of the interfacial transition zone (ITZ) between aggregate and paste, and concrete homogeneity. The goal of the study was to find optimal mixing procedures for production of a homogeneous and workable mixture and quality concrete using a two-stage mixing operation. The specific objectives of the study are as follows: (1) To achieve optimal mixing energy and time for a homogeneous cementitious material, (2) To characterize the homogeneity and flow property of the pastes, (3) To investigate effective methods for coating aggregate particles with cement slurry, (4) To study the effect of the two-stage mixing procedure on concrete properties, (5) To obtain the improved production rates. Parameters measured for Phase I included: heat of hydration, maturity, and rheology tests were performed on the fresh paste samples, and compressive strength, degree of hydration, and scanning electron microscope (SEM) imaging tests were conducted on the cured specimens. For Phases II and III tests included slump and air content on fresh concrete and compressive and tensile strengths, rapid air void analysis, and rapid chloride permeability on hardened concrete.

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Stage-discharge relations constitute a viable, alternative technique for estimating accurately flow for ungaged sites. In this research, we have utilized pressure transducers and Large Scale Particle Image Velocimetry techniques to develop stage-discharge relations at eleven sites in the Hungry Canyon Area (HCA) of southwestern Iowa under different hydrologic conditions. We have employed these data to calibrate and verify an established hydrologic model and then we have used this model to provide a stage discharge relation for different hydrologic conditions (i.e. rating curves). The benefits of the project are numerous including that the discharge data will be used for a number of purposes, including operational decision making in the HCA about the design of water-control and conveyance structures, input for hydraulic and hydrologic models, and calculation of sediment and other water quality constituents transport and “loads”, and for decision making. This project has also pointed out the difficulties in measuring flows in ungaged streams with ice jams, steep banks, erodible beds, and floating debris.

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El objetivo principal de este proyecto es desarrollar más a fondo y consolidar los objetivos formativos y competencias del grado en Estudios Ingleses a través de un trabajo de escritura creativa, en concreto, la creación de una obra teatral original. Este trabajo consiste en, por un lado, una introducción al Naturalismo, como género literario en un marco cultural y metodológico, y por otro lado, la creación personal de una obra naturalista que incluye la primera parte del manuscrito. Este proyecto incluye un proceso completo de creatividad justificado gracias a las principales teorías de algunos escritores naturalistas, como: Émile Zola – como precursor del Naturalismo – y August Strindberg como uno de los mayores mentores de este género literario. Los resultados obtenidos en este trabajo son: la creación de una obra teatral original, una especialización en el movimiento Naturalista aplicado al teatro contemporáneo, y un profundo conocimiento de la lengua inglesa a través de la perspectiva de un dramaturgo.

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The capabilities of a high-resolution (HR), accurate mass spectrometer (Exactive-MS) operating in full scan MS mode was investigated for the quantitative LC/MS analysis of drugs in patients' plasma samples. A mass resolution of 50,000 (FWHM) at m/z 200 and a mass extracted window of 5 ppm around the theoretical m/z of each analyte were used to construct chromatograms for quantitation. The quantitative performance of the Exactive-MS was compared with that of a triple quadrupole mass spectrometer (TQ-MS), TSQ Quantum Discovery or Quantum Ultra, operating in the conventional selected reaction monitoring (SRM) mode. The study consisted of 17 therapeutic drugs including 8 antifungal agents (anidulafungin, caspofungin, fluconazole, itraconazole, hydroxyitraconazole posaconazole, voriconazole and voriconazole-N-oxide), 4 immunosuppressants (ciclosporine, everolimus, sirolimus and tacrolimus) and 5 protein kinase inhibitors (dasatinib, imatinib, nilotinib, sorafenib and sunitinib). The quantitative results obtained with HR-MS acquisition show comparable detection specificity, assay precision, accuracy, linearity and sensitivity to SRM acquisition. Importantly, HR-MS offers several benefits over TQ-MS technology: absence of SRM optimization, time saving when changing the analysis from one MS to another, more complete information of what is in the samples and easier troubleshooting. Our work demonstrates that U/HPLC coupled to Exactive HR-MS delivers comparable results to TQ-MS in routine quantitative drug analyses. Considering the advantages of HR-MS, these results suggest that, in the near future, there should be a shift in how routine quantitative analyses of small molecules, particularly for therapeutic drugs, are performed.

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Long-term effects of trimethyltin (TMT) applied at concentrations below the cytotoxic level were examined in three-dimensional cell cultures of fetal rat telencephalon using biochemical, immunochemical and morphological criteria. It was found that in immature cultures low concentrations of TMT (10(-8) M) specifically induced a gliotic response in astrocytes, with increased immunoreactivity for glial fibrillary acidic protein, and a greater number of astrocytic processes. Significant changes in oligodendrocytic and neuronal parameters were found only at 10(-6) M of TMT. In differentiated cultures, distinct changes in cell type-specific parameters occurred at 10(-6) M of TMT (the lowest effective concentration). In addition, different patterns of responses were found for astrocytes and oligodendrocytes, as compared to immature cultures. These results suggest that among neural cells, astroblasts are most sensitive to TMT, and that the glial responses to this neurotoxicant are development-dependent.

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The aim was to investigate the efficacy of neoadjuvant docetaxel-cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m-2 (day 1) plus cisplatin 40 or 50 mg m-2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel-cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.

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Successful pregnancy depends on well coordinated developmental events involving both maternal and embryonic components. Although a host of signaling pathways participate in implantation, decidualization, and placentation, whether there is a common molecular link that coordinates these processes remains unknown. By exploiting genetic, molecular, pharmacological, and physiological approaches, we show here that the nuclear transcription factor peroxisome proliferator-activated receptor (PPAR) delta plays a central role at various stages of pregnancy, whereas maternal PPARdelta is critical to implantation and decidualization, and embryonic PPARdelta is vital for placentation. Using trophoblast stem cells, we further elucidate that a reciprocal relationship between PPARdelta-AKT and leukemia inhibitory factor-STAT3 signaling pathways serves as a cell lineage sensor to direct trophoblast cell fates during placentation. This novel finding of stage-specific integration of maternal and embryonic PPARdelta signaling provides evidence that PPARdelta is a molecular link that coordinates implantation, decidualization, and placentation crucial to pregnancy success. This study is clinically relevant because deferral of on time implantation leads to spontaneous pregnancy loss, and defective trophoblast invasion is one cause of preeclampsia in humans.